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dc.contributor.authorCid Silva, Purificación 
dc.contributor.authorMargusino Framinan, Luis 
dc.contributor.authorBalboa Barreiro, Vanesa
dc.contributor.authorPernas Souto, Berta 
dc.contributor.authorMena de Cea, Alvaro 
dc.contributor.authorMartín Herranz, Isabel 
dc.contributor.authorCastro Iglesias, Angeles 
dc.contributor.authorPoveda López, Eva 
dc.date.accessioned2022-02-01T12:58:48Z
dc.date.available2022-02-01T12:58:48Z
dc.date.issued2019
dc.identifier.issn2325-9582
dc.identifier.otherhttps://www.ncbi.nlm.nih.gov/pubmed/30798655es
dc.identifier.urihttp://hdl.handle.net/20.500.11940/16045
dc.description.abstractBACKGROUND: Current HIV treatment guidelines recommend antiretroviral treatment (ART) initiation for all HIV-infected individuals regardless of CD4 count. This study evaluates the immunological and virological status and the clinical characteristics of patients who have started ART in the last 8 years in the Northwest of Spain. METHODS: All HIV-infected patients who have started ART between January 2009 and December 2016 at a reference hospital in the Northwest of Spain were included in this retrospective observational study. Epidemiological, clinical, and immunovirological features and antiretroviral drugs used for initiation were recorded. A statistical analysis was performed using SPSS version 19 software. Categorical and continuous variables were compared by the specific statistical tests, and a logistic regression model was used to identify time associated with Center for Disease Control and Prevention (CDC) categories change. RESULTS: A high proportion of HIV-infected patients (66.7%) had initiated ART with CD4 counts <350 cells/mm(3) in the last 8 years. From these, most of them (68.3%) had <350 CD4 counts at first contact with HIV specialist medical team, 12.2% had no indications for ART initiation in the last clinic visit before ART initiation according to the national guidelines at that moment, 11.0% were lost to follow-up because of lack of compliance with scheduled visits and 8.5% of patients refused treatment. A logistic regression model showed that a delay of one month since the first contact with HIV specialist medical team to ART initiation involves a risk of worsening in the CDC clinical category (odds ratio: 1.02 [95% confidence interval: 1.012-1.029]; P < .001). A trend towards an earlier start of ART was observed during 2015 and 2016, likely influenced by the last treatment guidelines recommendations. CONCLUSION: High proportion of HIV-infected patients (66.7%) had initiated ART with CD4 counts <350 cells/mm(3) in the last 8 years. The main reasons for this problem were analyzed and an important rate of late diagnosis was identified. However, a trend towards an earlier start of ART was observed during 2015 and 2016, likely influenced by the last treatment guidelines recommendations. These findings highlight the need to promote and facilitate HIV testing to reduce the late diagnosis as well as counseling on HIV prevention, treatment, and linkage care.en
dc.language.isoenges
dc.rightsAtribución-NoComercial 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/*
dc.subject.meshTime-to-Treatment *
dc.subject.meshLongitudinal Studies *
dc.subject.meshAdult *
dc.subject.meshDelayed Diagnosis *
dc.subject.meshCD4 Lymphocyte Count *
dc.subject.meshMiddle Aged *
dc.subject.meshHumans *
dc.subject.meshAnti-HIV Agents *
dc.subject.meshRetrospective Studies *
dc.subject.meshPractice Guidelines as Topic *
dc.subject.meshHIV Infections *
dc.titleLate HIV Diagnosis but Earlier Antiretroviral Treatment Initiation in Northwest Spain: Impact of Current Treatment Guidelinesen
dc.typeArtigoes
dc.identifier.doi10.1177/2325958218821940
dc.identifier.pmid30798655
dc.identifier.sophos33929
dc.journal.titleJ Int Assoc Provid AIDS Carees
dc.organizationServizo Galego de Saúde::Estrutura de Xestión Integrada (EOXI)::EOXI de A Coruña - Complexo Hospitalario Universitario de A Coruña::Farmaciaes
dc.organizationServizo Galego de Saúde::Estrutura de Xestión Integrada (EOXI)::EOXI de A Coruña - Complexo Hospitalario Universitario de A Coruña::Medicina Internaes
dc.organizationSERGAS::Área Sanitaria de A Coruña e Cee::INIBIC.- Instituto de Investigación Biomédicaes
dc.organizationServizo Galego de Saúde::Estrutura de Xestión Integrada (EOXI)::EOXI de A Coruña - Complexo Hospitalario Universitario de A Coruña::Epidemioloxíaes
dc.page.initial2325958218821940es
dc.relation.publisherversionhttps://journals.sagepub.com/doi/pdf/10.1177/2325958218821940es
dc.rights.accessRightsopenAccesses
dc.subject.decsdiagnóstico tardío *
dc.subject.decstiempo hasta el tratamiento *
dc.subject.decsestudios longitudinales *
dc.subject.decsestudios retrospectivos *
dc.subject.decsmediana edad *
dc.subject.decsrecuento de linfocitos CD4 *
dc.subject.decshumanos *
dc.subject.decsguías de práctica clínica como asunto *
dc.subject.decsfármacos anti-VIH *
dc.subject.decsadulto *
dc.subject.decsinfecciones por VIH *
dc.subject.keywordCHUACes
dc.typefidesArtículo Originales
dc.typesophosArtículo Originales
dc.volume.number18.es


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Atribución-NoComercial 4.0 Internacional
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